The spontaneous perforation of sinus of Valsalva without congenital anomaly such as aneurysm and trauma has not been
reported. We report a 66-year-old female presenting with ST elevation myocardial infarction due to compressing the
proximal part of right coronary artery by hematoma attributed to spontaneous perforation of sinus of Vaslava. The patient
was stabilized after surgical primary repair.